Provider Demographics
NPI:1902341381
Name:LESTINA, KELLY (ARNP)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:
Last Name:LESTINA
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:KELLY
Other - Middle Name:
Other - Last Name:SPURRIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:5100 PRAIRIE PKWY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CEDAR FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50613-8155
Mailing Address - Country:US
Mailing Address - Phone:319-553-0828
Mailing Address - Fax:319-277-7548
Practice Address - Street 1:5100 PRAIRIE PKWY
Practice Address - Street 2:SUITE 101
Practice Address - City:CEDAR FALLS
Practice Address - State:IA
Practice Address - Zip Code:50613-8155
Practice Address - Country:US
Practice Address - Phone:319-553-0828
Practice Address - Fax:319-277-7548
Is Sole Proprietor?:No
Enumeration Date:2016-12-21
Last Update Date:2016-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA119207363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily